Transcranial Doppler velocity and associations with delayed cerebral ischemia in aneurysmal subarachnoid Hemorrhage.
Transcranial Doppler velocity and associations with delayed cerebral ischemia in aneurysmal subarachnoid Hemorrhage.
- 2020
BACKGROUND AND PURPOSE: We evaluated optimal transcranial Doppler (TCD) measures for predicting delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH). CONCLUSIONS: We found that relative increases in TCD velocities in the MCAs during the first 7 days (with a threshold increase of 53.4 cm/s from days 2 to 7) after aSAH admission were independently associated with DCI. This association requires independent confirmation. Copyright (c) 2020 Elsevier B.V. All rights reserved. MATERIAL AND METHODS: Consecutive patients with aSAH and daily middle cerebral artery (MCA) TCD recordings were retrospectively analyzed. Change in TCD velocity was obtained by creating a smoothing curve. Change in TCD velocity was determined with a linear regression model that confirmed greatest change in velocity associated with DCI occurred at days 2-7. Multivariate logistic regression analysis was then completed. RESULTS: 95 patients were evaluated. Increase in TCD velocity at days 2-7 proved to be the best predictor for DCI with an optimal cutoff of 8.9 cm/s/day (p = .019) and AUC 0.651. Multivariate logistic regression analysis using DCI as outcome showed that poor admission Hunt-Hess scores (OR 5.02, 95%CI 1.22-22.67, p = .028) and increases in TCD velocity (OR 5.32, 95%CI 1.41-23.33, p = .018) were independently associated with DCI.
English
0022-510X
10.1016/j.jns.2020.116934 [doi] S0022-510X(20)30271-9 [pii]
IN PROCESS -- NOT YET INDEXED
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Neurosurgery
Radiology
Surgery/Surgical Critical Care
Journal Article
BACKGROUND AND PURPOSE: We evaluated optimal transcranial Doppler (TCD) measures for predicting delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH). CONCLUSIONS: We found that relative increases in TCD velocities in the MCAs during the first 7 days (with a threshold increase of 53.4 cm/s from days 2 to 7) after aSAH admission were independently associated with DCI. This association requires independent confirmation. Copyright (c) 2020 Elsevier B.V. All rights reserved. MATERIAL AND METHODS: Consecutive patients with aSAH and daily middle cerebral artery (MCA) TCD recordings were retrospectively analyzed. Change in TCD velocity was obtained by creating a smoothing curve. Change in TCD velocity was determined with a linear regression model that confirmed greatest change in velocity associated with DCI occurred at days 2-7. Multivariate logistic regression analysis was then completed. RESULTS: 95 patients were evaluated. Increase in TCD velocity at days 2-7 proved to be the best predictor for DCI with an optimal cutoff of 8.9 cm/s/day (p = .019) and AUC 0.651. Multivariate logistic regression analysis using DCI as outcome showed that poor admission Hunt-Hess scores (OR 5.02, 95%CI 1.22-22.67, p = .028) and increases in TCD velocity (OR 5.32, 95%CI 1.41-23.33, p = .018) were independently associated with DCI.
English
0022-510X
10.1016/j.jns.2020.116934 [doi] S0022-510X(20)30271-9 [pii]
IN PROCESS -- NOT YET INDEXED
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Neurosurgery
Radiology
Surgery/Surgical Critical Care
Journal Article